Canada’s pediatricians set to reveal new policy on circumcision

Canada’s pediatricians are about to update their advice on whether baby boys should be circumcised, revising their stand for the first time in 17 years.

Their review comes as new Canadian research suggests half of expectant parents would consider circumcision if they had a son — and that the single most important factor is the circumcision “status” of the father.

“There isn’t going to be a ‘prescription’ for Canadian males in terms of circumcision,” society president Dr. Richard Stanwick, chief medical health officer for the Vancouver Island Health Authority, told Postmedia News.

The organization has been struggling to put forward a balanced position “that captures the risks, and the benefits, but is also respectful of personal preferences, religious issues and many other things that dictate this decision,” Stanwick said.

The issue is so loaded with emotion and controversy that the new statement has been three years in the making. “There are very strong opinions on both sides of this issue,” Stanwick said.

“We know that we’re wading into something that, no matter what we write, will not be strong enough for probably either side.”

Last year, the American Academy of Pediatrics announced that the health benefits of newborn male circumcision outweigh the risks, a move that provoked demonstrations by anti-circumcision activists who view the procedure as genital mutilation of newborns.

The old policy deemed circumcision medically unnecessary for the “well-being of the child.”

But after a special task force reviewed more than 1,000 studies published over the past 15 years, the American doctors’ group now says that circumcision provides protection against urinary tract infections, penile cancer and the transmission of some sexually transmitted infections, including HIV.

The organization isn’t recommending universal circumcision. Instead, it says the final decision should be left to parents.

Circumcision involves the surgical remove of some, or all, of the foreskin from the penis. It is one of the most common surgical procedures performed worldwide. In hospitals, the procedure is usually performed by obstetricians soon after birth.

“Clearly there has been a lot of literature around the potential role of the avoidance of infection,” Stanwick said.

“But this also has to be balanced off against the fact that this is still a surgical procedure, and it is not without risk.”

Those risks can include bleeding and hemorrhage, infection, inflammation and tightening at the end of the penis.

Any shift in policy would have to ensure, “are there enough skilled professionals around to do this, so that we don’t have a complication rate that is unacceptable and so that we’re not seeing males being significantly harmed by not having the properly trained people to do it,” Stanwick said.

The new policy statement is expected to be released before the pediatric group’s annual meeting in June.

“It would be great if we had absolute answers, but on this one, I don’t think we will,” Stanwick said.

“At the end of the day . . . it will very much be influenced by dad’s status, as well as the cultural and religious issues.”

A new study found that the circumcision rates are heavily influenced by whether or not the father is circumcised.

University of Saskatchewan researchers, in a study published in the journal Canadian Family Physician, surveyed 230 parents attending prenatal classes in Saskatoon.

Overall, half — 56 per cent — said they would consider pursuing circumcision if they had a son. In cases where the father of the expected baby was circumcised, 82 per cent were in favour of circumcision, versus 15 per cent when the father wasn’t circumcised.

According to the researchers, Canada’s current circumcision rate is 32 per cent. In the U.S., rates are increasing, to 61 per cent of men, they said.